Each year on October 29th people around the world unite to recognize World Stroke Day, and the World Health Organization plays a pivotal role in this global observance. This annual event serves as a poignant reminder of the significant threat posed by strokes on a worldwide scale. The World Health Organization’s mission is to enhance our understanding of stroke and take concerted steps to prevent and mitigate their impact, ultimately contributing to a healthier world. For more research you can also visit NHS.
What is a Stroke?
A stroke happens when a blockage or bleeding in blood vessels stops or reduces blood flow to the brain. This means the brain doesn’t get enough oxygen and nutrients, which leads to brain cells dying. Stroke is a type of disease that affects the blood vessels supplying oxygen to the brain. If the brain doesn’t get enough oxygen, it can be damaged. Having a stroke is a medical emergency. While many strokes can be treated, some can cause disability or even death.
What are the Types of Stroke?
Stroke is the fifth most common cause of death in the United States. Nearly 800,000 people have a stroke each day, which means about one person has a stroke every 40 seconds. There are three main types of stroke:
Ischemic Stroke: This is the most common type, accounting for 87% of all cases. It happens when a blood clot blocks blood and oxygen from getting to a part of the brain.
Hemorrhagic Stroke: This occurs when a blood vessel bursts. It’s often caused by aneurysms or arteriovenous malformations (AVMs).
Transient Ischemic Attack (TIA): This happens when blood flow to a part of the brain is briefly reduced. Normal blood flow returns quickly and the symptoms go away without treatment. Some people call this a “ministroke”.
What are the Symptoms of Stroke?
The symptoms of a stroke often come on suddenly and without warning. Some main symptoms include:
- Confusion, trouble speaking, or understanding speech.
- Headache, sometimes with changes in consciousness or vomiting.
- Numbness or weakness in the face, arm, legs, especially on one side of the body.
- Vision problems in one or both eyes.
- Difficulty walking, dizziness, or lack of coordination.
Having a stroke can lead to long-term health issues. Depending on how quickly it’s diagnosed and treated, a person might have temporary or permanent disabilities. Additional symptoms may include:
- Problems controlling bladder or bowel.
- Feeling depressed.
- Paralysis or weakness on one or both sides of the body.
- Trouble controlling or expressing emotions.
Symptoms can vary in severity, remembering the acronym “FAST” can help recognize stroke symptoms:
- Face Drooping: Does one side of the face droop when the person tries to smile?
- Arm Weakness: Does one arm drift down when the person tries to raise both arms?
- Speech Difficulty: Is speech slurred or unusual when the person tries to repeat a simple phrase?
- Time to Act: If any of these symptoms occur, call emergency services immediately.
Getting treatment quickly is crucial for a better outcome. Acting fast reduces the risk of permanent brain damage or death.
What are the Causes and Risk Factors of Stroke?
Some research has shown that men are more likely to die from stroke than women. However, a review of studies from 2016 suggests that these differences might not be solely because of gender. Factors like race, age, how severe the strokes are and other risks need to be considered. The review explains that the risk of dying from stroke often goes up as people get older and due to demographic factors, rather than just because of biological differences between men and women. Another analysis from 2016 found that African American individuals have a much higher chance of having their first stroke. They’re also about 60% more likely to have another stroke within 2 years. Each type of stroke can have various causes, but in general, a person is more likely to have a stroke if they:
- Have overweight and obesity
- Are 55 years of age or older
- Have a personal or family history of stroke
- Having a high blood pressure
- Have diabetes
- Have high cholesterol
- Have heart disease
- Have carotid artery disease
- Have vascular disease
- Are sedentary
- Consume alcohol excessively
- Smoke
- Use illicit drug
What is the Diagnosis of Stroke?
Stroke starts suddenly. For the best chance of recovery, it’s important for a person to get treatment at a hospital within 3 hours of when their symptoms start. Doctors have several tests they can use to figure out what types of stroke a person is having. These tests include:
- Physical examination
- Blood tests
- CT scan
- MRI scan
- Carotid ultrasound
- Cerebral angiogram
- Echocardiogram
- Electrocardiogram
It is only possible to confirm the type of stroke using a brain scan in a hospital environment.
What is the Treatment of Stroke?
Because ischemic and hemorrhagic strokes have different causes and effects on the body, they need different treatments. Quick diagnosis is crucial for minimizing brain damage and allowing the doctor to use the right treatment for the type of stroke. Below are treatment options for ischemic stroke and hemorrhagic stroke, along with some general tips for rehabilitation for both types.
Ischemic Stroke:
It happens when arteries get blocked and narrowed. Treatment focuses on getting enough blood flow back to the brain. Treatments usually start with drugs that break down clots and stop new ones from forming. Doctors might give blood thinners like aspirin or a shot of tissue plasminogen activator (TPA). TPA is really good at dissolving clots, but it needs to be given within 4.5 hours of when the stroke symptoms start. In emergencies, doctors might give TPA directly into an artery in the brain or use a catheter to physically remove the clot. Researchers are still studying how helpful these procedures are. There are other surgeries that can help lower the risk of strokes or TIAs. One is called carotid endarterectomy, where doctors open up the carotid artery and remove plaque that could break off and go to the brain. Another option is angioplasty. In this, a surgeon puts a small balloon into a narrowed artery using a catheter. They put in a mesh tube, called a stent, to keep the artery from narrowing again. They can include:
- Clot-breaking drugs
- Mechanical thrombectomy
- Stents
- Surgery
Hemorrhagic Stroke:
It happens when blood leaks into the brain. Treatments Aims to stop the bleeding and relieve pressure on the brain. Treatment often starts with medications to lower pressure in the brain, control blood pressure, prevent seizures and relax blood vessels. If someone is taking blood-thinning medications like warfarin or clopidogrel, they may receive drugs to reverse the effects of these medications. Surgeons can fix certain blood vessel problems that cause or could cause hemorrhagic strokes. For example, if an aneurysm (a bulge in a blood vessel that might burst) causes the stroke, a surgeon can place small clamps at the base of the aneurysm or fill it with coils to stop the bleeding and shrink the aneurysm. If the bleeding is because of an arteriovenous malformation (AVM), a surgeon can remove it. AVMs are abnormal connections between arteries and veins that can bleed. They can include:
- Medications
- Coiling
- Clamping
- Surgery
Rehabilitation:
Experiencing a stroke can be life-altering and have long-lasting physical and emotional impacts. Recovering well from a stroke typically requires targeted therapies and support system, such as:
- Speech therapy
- Cognitive therapy
- Relearning sensory skills
- Physical therapy
- Occupational therapy
- Supports groups
- Supports from friends and family
Rehabilitation is a crucial and continuous aspect of stroke care. With proper help and support from family and friends, it’s often possible to regain a normal quality of life, depending on how severe the stroke was. The most common stroke medications include:
- Direct-acting oral anticoagulants (DOACs)
- Tissue plasminogen activator (tPA)
- Anticoagulants
- Antiplatelet drugs
- Statins
- Blood pressure drugs
What is the Prevention of Stroke?
The most effective way to prevent a stroke is by dealing with its root causes. People can do this by making lifestyle changes such as:
- Eating a healthful diet
- Maintaining a moderate weight
- Exercise regularly
- Not smoking tobacco
- Avoiding alcohol, or only drinking moderately
Eating a nutritious diet means including plenty of:
Make sure to reduce the intake of red and processed meats in your diet, as well as high cholesterol and saturated fats. Also, aim to consume salt in moderation to maintain healthy blood pressure levels. Other steps a person can take to lower the risk of stroke include:
- Controlling their blood pressure levels
- Managing diabetes
- Getting treatment for heart disease
In addition to adopting these lifestyle changes, taking anticoagulant or antiplatelet medications can help lower the risk of having another stroke. Surgery on the coronary arteries, carotid arteries, or brain aneurysms can also decrease the chance of further strokes, as can some other surgical options currently being researched.
What to Know About Clonus?
Clonus is a condition where muscles contract on their own, causing shaking movements that a person can’t control. It happens when muscles get stretched too much. People with clonus feel their muscles twitching quickly and repeatedly, not like the usual occasional muscle twitching. Clonus mostly happens in the muscles around the knees and ankles. Sometimes, it can affect other parts of the body too like the:
- Wrist
- Fingers
- Jaws
- Elbows
What are the Causes of Clonus?
The exact reason for clonus isn’t completely understood yet. It usually happens when there’s a problem with how the body sends signals for muscles to move. Clonus is often seen in conditions that cause muscle spasms. Some conditions that can lead to clonus include:
- Amyotrophic lateral sclerosis (ALS), a rare disease that affects muscle control and movement, sometimes called Lou Gehrig’s disease.
- Brain injury
- Cerebral palsy
- Certain metabolic disease like Krabbe disease
- Hereditary nerve diseases such as hereditary spastic parapelgia, which affects the spinal cord and leads to a gradual loss of muscle control.
- Multiple sclerosis (MS)
- Serotonin toxicity
- Spinal cord injury
- Strokes
Sometimes, liver or kidney failure can also clonus because of a buildup of waste products in the body that affects normal brain function.
Clonus and Spasticity:
When someone has clonus, they often also experience spasticity, which means their muscles are unusually tight for a long time. In clonus spasticity happens because the nerve connecting the brain, spinal cord, and muscles are damaged. This causes the muscles to move on their own, leading to stiffness, pain, and involuntary contractions. Others problems that can happen alongside clonus include:
- Strong reflexes in response to tapping a tendon
- Joints that becomes stiff and can’t move called contractions
- Muscles becoming tighter than usual known as hypertonicity
- Legs crossing over involuntary, sometimes called scissoring
Clonus and Multiple Sclerosis:
Clonus is often linked with multiple sclerosis (MS), a condition affecting the central nervous system, which messes up communication between the brain and the body. MS can lead to muscles moving on their own. MS is a progressive illness, meaning it can worsen over time if not treated. Treatment for MS can help manage muscle spasticity and clonus. Early symptoms of multiple sclerosis include:
- Vision problems
- Tingling and numbness
- Pains and spasms
- Weakness or fatigue
- Balance problem
- Dizziness
- Sexual dysfunction
- Cognitive problems
What is the Diagnosis of Clonus?
Clonus is a condition that lasts a long time. To treat it, your doctor first needs to figure out if you have it. Your doctor will start by checking your body during a physical exam. They’ll focus on the areas where you feel the most contractions and pain. If you have muscle contractions while you’re at the doctor’s office, they’ll count how many times it happens. Your doctor might also order some tests to confirm clonus and check for any other health issues you might have. These tests could include:
- Tests to see how well you can balance and coordinate your movements
- Blood tests
- MRI scans of your brain
- Samples of fluid from your spine
There isn’t just one test to find out what’s causing clonus. You might need to take a few tests before your doctor can say for sure.
What are the Treatments of Clonus?
Treating clonus using a mix of medicines and therapies. You should discuss these options with your doctors to see what might work best for you. It might take some trial and error to find the right treatment.
Medications:
Medicines, mostly muscle relaxants and sedatives, can help lessen clonus symptoms and muscle tightness. Some common ones are:
- Baclofen, which relaxes muscles
- Clonazepam (Klonopin), a sedative
- Diazepam (Valium), another sedative
- Tizanidine (Zanaflex), a muscle relaxant used if baclofen doesn’t work
These medicines might make you feel sleepy, so it’s not safe to drive while taking them. They can also cause side effects like:
- Feeling dizzy
- Confusion
- Tiredness
- Feeling lightheaded
- Trouble walking
Talk to your doctor about all the benefits with these types of medicines.
Other Therapies:
Some people find relief from clonus with Botox injections. Botox, often used for wrinkles, relaxes muscles. But its effects wear off, so you need regular injections. Physical therapy can help too. A therapist might use exercises and stretches to improve movement and reduce symptoms.
Home Remedies:
You can also ease clonus at home. Cold packs can soothe sore muscles, and heat pads can relieve pain. Stretching exercises might help too. Some people find wrist and ankle splints recommended by professionals useful.
Surgery:
Surgery is usually a last option if medicines and therapy don’t work. It involves cutting nerves to stop abnormal muscle movements.
FAQs:
Which country has the highest stroke?
At a country level, the highest rates were in the United Arab Emirates at 208, Mace at 187 and Jordan at 181. So while the lowest rates were in Ireland at 36, Nepal at 37 and Switzerland at 38 strokes per 100,000 people.
What are the global stats on stroke?
Globally, one in four people over age 25 will have a stroke in their lifetime. 15-49 years 1978,946,50.29 (43.02 -58.71)- Each year over 16% of all strokes occur in people 15-49 years of age. <70 years 7622, 088,104.79 (92.54-119.06)-Each year over 62% of all strokes occur in people under 70 years of age.
Who is at greatest risk of stroke?
People 55 or older have a higher risk of stroke than younger people. So African, American and Hispanic patients have a higher risk of stroke than people of other races. Men have a higher risk of stroke than women.
Can MRI detect a stroke?
So Depending on the type of the machine, an MRI can potentially detect new strokes within a minute. An MRI can also detect old strokes for decades after they happen. The fastest type of MRI is diffusion-weighted imaging (DWI). It measures shifts in fluids in the brain and can detect a stroke soon after its onset.
What is the lab test for s stroke?
The test can detect brain tissue damaged by an ischemic stroke and brain hemorrhages. Sometimes a dye is injected into a blood vessel to view the arteries and veins and highlight blood flow. So this test is called magnetic resonance angiography or magnetic resonance venography.
Can you live 20 years after a stroke?
For example, 79% of people survive 2 years, 61% survive 3 years, So 5% survive 16 years and only 1% survive 20 years.
What is the right side brain stroke?
So a right side brain stroke happens when blood supply to the right side of the brain is stopped. The right side of the brain is in charge of the left side of the body. It also does some thought processing, helps us know body position, and judge space and distance. There are two main types of stroke: ischemic and hemorrhagic.
